EP311: How Aging in Place Becomes a Business Problem for FFS Providers, With Sumit Nagpal

This episode might be about local providers getting disintermediated not by virtual front doors like I discussed with Jeff Hogan in EP309 but by entities providing virtual continuous care at home. Predictivae and proactive, the idea is to help reduce acute events requiring on-premises care. But if someone does wind up needing ramped-up care, they can get it hospital at home or SNF (skilled nursing facility) at home instead of them going anywhere. So, there’s a baseline level of home monitoring followed by periods where care is stepped up. The point is, everything is going down at home with the care coming to the person at the care level that they need, so it ramps up or down depending on what they’re going through or need at the time. 

I’m talking in this health care podcast with Sumit Nagpal, CEO and founder over at Cherish Health. We talk about the goings-on in the whole aging in place or, as he calls it, living in place vertical. A couple of takeaways from our conversation I think are notable: First of all, who is going to drive first change here isn’t going to be, for example, hospital systems at scale suddenly deciding to work against their own perverse incentives to keep heads out of beds. Our first movers here—the ones who will push assisted living at home or SNF at home or CCRC at home or whatever you want to call it at home—is going to be consumers and their families who either can’t afford to or don’t want to send Grandma to an assisted living institution.

So, this is how it’s gonna go down: Families across the country install technology to keep Grandma safe at home. A natural ally here, if you think about it, is Big Retail, by the way. Why wouldn’t Big Retail and Big Tech sell these solutions to grandmas’ families like they sell televisions today? But the second that grandmas everywhere have monitoring software in their homes is the second that FFS-dependent hospitals and other providers have a problem on their hands—a business problem, that is. And assisted living facilities and SNFs working a similar model are in the same boat.

Here’s why. Actionable population heath data is now available, and once that data is available and looked at predictively and proactively, grandmas are not going to go to the ER like they once were for two reasons: (1) Proactive and predictive technology in the home will reduce acute events and (2) because if and when Grandma does have an acute event, she’s not calling an ambulance. The technology is notifying someone. Maybe it’s notifying the Medicare Advantage plan that Grandma’s on, who has realized the power of all this at-home stuff. And the Medicare Advantage plan maybe just hooked up with a forward-thinking hospital that built an ER at home service or a hospital at home service. Or maybe there’s some national technology player who is providing similar services.

Sumit Nagpal and I talk through how this might look and also the essential factors for the health care industry to eventually adopt an at-home model.

You can learn more at cherishhealth.com.

Sumit Kumar Nagpal is the CEO and founder of Cherish Health, a consumer electronics company that develops advanced sensors and artificial intelligence combined with medical evidence and human touch. Cherish Health solutions improve the lives and enable the supported self-care of people aging or living with health challenges—our grandparents, parents, children, many of us.

Sumit is a serial entrepreneur and has cofounded and grown five digital health companies over the past two and a half decades that have tackled progressively bolder challenges facing our health care economies. He serves on important industry boards, including HIMSS and Health eVillages. Prior to founding Cherish Health, Sumit was global lead for digital health strategy at Accenture. He is sought after for his expertise and unstoppable energy as an entrepreneur, change agent, strategist, and technology architect.

03:55 What does “health care is coming home” truly mean?
07:35 “It’s not like we’re cheese and we’re aging in place. We’re living. We’re living our lives.”
07:51 “Give us the ability to live where we want for as long as we want as safely as possible.”
10:31 “The challenge with wearables beyond the initial cost is … you have to remember to wear them.”
10:53 “The tech itself is not unreliable, but we as human beings are unreliable.”
13:34 “The conversation typically begins with privacy and goes into other kinds of risks.”
15:50 “Our health care economy is fundamentally misaligned.”
17:57 “The incentives … today don’t really enable this kind of proactive, preventive engagement.”
23:30 How do we solve this cost problem at scale?
23:44 How do you align incentives for those that will care to solve these problems?
26:47 “I don’t think that we’re going to have mass, large-scale change in health care moving home until people are starting to adopt … these kinds of services in their homes.”

You can learn more at cherishhealth.com.